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This phenomenon has been designated by several terms, including pseudoalcoholic hepatitis, diabetic hepatitis, fatty-liver hepatitis, alcohol-like e journal hepatitis, but currently nonalcoholic steatohepatitis (NASH) remains the most popular appellation. Analysis of liver biopsy specimens is the cornerstone of diagnosis. NASH is defined by the presence of macrovesicular fatty changes (steatosis) and lobular inflammation in the absence of alcoholism. NASH is most frequently associated with obesity, diabetes and hyperlipidemia and e journal one could consider this combination as a primary entity (Primary NASH), while secondary disease is related to other metabolic factors, drug treatments, surgical procedures for treatment of obesity e journal and miscellaneous factors (see Table 1). Table 1 Nonalcoholic Steatohepatitis Primary Nash ·Obesity ·Diabetes ·Hyperlipidemia Secondary Nash Drug Treatments -Amiodarone -Perhexilene Maleate -Glucocorticoids -Synthetic Estrogens -Tamoxifen Surgical Procedures -Jejunal bypass -Gastroplasty for Morbid Obesity -Biliopancreatic Diversion -Extensive Small-Bowel Resection Other Metabolic Factors -Total Parenteral Nutrition -Acute Starvation -Rapid Weight Loss ·Miscellaneous -Bacterial overgrowth(jejunal diverticulosis) -Limb Lipodystrophy -Abetalipoproteinemia -Weber-Christian Disease The diagnosis
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